MEDICARE: DR. ELIZABETH ROBBINS ROSENTHAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	102754	NY

General Provider Information

NPI Number	:	1336147826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH ROBBINS ROSENTHAL M.D.

Provider Business Mailing Address
First Line	:	1600 HARRISON AVE
Second Line	:	SUITE 303
City	:	MAMARONECK
State	:	NY
Zip	:	10543-3145
Country	:	US
Telephone Number	:	914-698-2190
Fax Number	:	914-698-0308

Provider Business Practice Location Address
First Line	:	1600 HARRISON AVE
Second Line	:	SUITE 303
City	:	MAMARONECK
State	:	NY
Zip	:	10543-3145
Country	:	US
Telephone Number	:	914-698-2190
Fax Number	:	914-698-0308

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	12/11/2007

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